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Volume VII |
Number 1 |
March 1994 |
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SUMMARIES
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SOME EPIDEMIOLOGICAL DATA REGARDING BURN PATIENTS TREATED DURING 1992 IN ALBANIA
(Belba G.J., Andrea A., Dauti I., Osmani X.H., Cano N., Pema L. - Albania)
The authors give some epidemiological data on bums based in particular on results obtained in 1992. The discussion mainly concerns the aetiological causes of the bums, methods of surgical treatment according to wound depth, hospitalization and the mortality rate. It is imperative to launch a medical propaganda campaign to ensure an aseptic environment and early necrectomy. Some comparative data are also given in relation to other Mediterranean Bums Club member countries.
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EVOLUTION DES ACCIDENTS PAR BRULURE 1985 - 1990 A SONATRACH
(Sidani R. - Algérie)
L'auteur prend en considération les accidents par brûlure qui se sont produits dans la période 1985-90 en rélation directe ou indirecte avec les activités de la Sonatrach, une compagnie algérienne engagée dans la production et la vente du pétrole, avec l'intention d'analyser les facteurs de risque enjeu et de trouver des méthodes pour supprimer ou réduire les dangers, pour ce qui concerne la fréquence et la gravité dés accidents, et de proposer le comportement correct et les mesures les plus appropriées pendant les diverses phases de la prise en charge du travailleur brûlé.
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CIVILIAN AND MILITARY BURN INJURIES: A COMPARATIVE STUDY
(Reda Mabrouk AM. - Egypt)
A comparative study is made of burns sustained in civilian life and those sustained under war conditions. The different causes of the two types of bum are reviewed, and the ways in which individuals are affected. The management of civilian and military bums is also considered. In the case of civilian burns continued care frequently depends on the financial resources available to the burn victim, whereas military bum victims are not affected by economic considerations. The importance of research work and training is emphasized. It is concluded that although civilian and military bums may present different problems in management the ultimate aim in both cases in the same - the well-being of the patient. This study is the result of personal experience in dealing with civilian and military burn injuries. "Military burn injuries" means injuries sustained during war.
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MANAGEMENT OF EXTENSIVE BURNS: A CASE REPORT
(Osman 0. F. - Saudi Arabia)
An adult male patient aged 32 years sustained flame bums involving 95% of his body surface area (60% deep). Lactated Ringer's solution was used for resuscitation. Fresh plasma and whole blood were given early and repeated when indicated. Early enteral and parenteral nutritional support and systemic antibiotics were employed. Wound debridement was continued with hydrotherapy and topical silver sulphadiazine cream. Physiotherapy and active and passive splinting were offered. Amniotic membrane was used as a biological wound dressing. Autografting was completed in four successive surgical sessions. The patient was discharged for further rehabilitation, physiotherapy and surgical reconstruction at the end of four months' hospitalization.
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PRISE EN CHARGE D'UNE PATIENT BRULE ALGIQUE EN PRE-HOSPITALIER
(Fonrouge J.M., Lakdja F. - France)
Les mécanismes physiopathologiques de la douleur sont de mieux en mieux connus, et aujourd'hui on parle de douleur nociceptive, neuropathique et idiopathique. Le comportement du patient peut permettre de reconnaître un processus douloureux avant que le patient ne l'exprime. Prendre en charge un patient brûlé en pré-hospitalier nécessite une capacité d'identifier et de traiter la ou les douleurs initiales, la douleur due au stress et les douleurs iatrogènes. Il faut donc savoir choisir la sédation adaptée.
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ASPECTS PSYCHOLOGIQUES DE LA THERAPRE DES GRANDS BRULE
(Arrigoni MR, Zermani R. - Italy)
Les auteurs soulignent l'importance, dans la thérapie psychologique du grand brûlé, de la "contenance" (ce terme indique une rélation entre deux esprits, dont l'une est en mesure de recevoir et de soutenir le matériel qui provient de l'autre). Les divers aspects psychologiques sont pris en considération, du point de vue non seulement du patient mais aussi des soignants. Au début les soignants doivent assumer toute la responsabilité d'un rôle adulte aux côtés d'un patient qui vit une régression temporaire, et pendant les soins, quand I& travail de contenance exige une concentration plus intense, on a recours à l'action coordonnée de deux infirmières présentes, dont l'une se dédie au travail technique et l'autre se concentre sur une action consolatrice. Les charges émotionnelles impliquées dans tous les divers aspects de la thérapie psychologique du grand brûlé rend indispensable une formation permanente pour l'équipe soignante.
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THE USE OF TISSUE EXPANSION IN BURNS SEQUELAE
(Pérez Barrero P., Duato F., Agullô A., Gonzàles Labasa M., Vistôs J.L., Cimorra G.A. - Spain)
Tissue expansion has become a very useful tool in the reconstruction of aesthetic and functional burns sequelae. In this paper we review a series of 56 expansions in 44 patients with burns sequelae treated in our department. We describe the technique and complications. According to our experience, the use of soft-tissue expansion for the reconstruction of scarred deformities in burn patients has proved to be a technique with optimal aesthetic and functional results. We therefore believe that controlled tissue expansion should be considered an extremely useful technique in the burn patient and should he selected when considered as an alternative.
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THE USE OF TEMPORAL ARTERY FLAPS IN DEFECTS OF THE HEAD AND NECK
(Stamatopoulos C., Alexakis R, Tsoutsos D., Michaelidis Ch., Kastana 0., loannovich J, Soumilas A. - Greece)
The temporal artery and the temporary vein are vessels with a constant anatomical course, large diameter and long axis with no deviations in the zygomaticotemporal region. The distribution of the contributory vessels is such that it allows dissection of flaps from the scalp and forehead. Dissection of the various flaps is facilitated by the existence of the fascia temporalis, which clarifies the position of the vessels. These characteristics of temporalis flaps broaden their versatility in the reconstruction of post-burn defects of the head and neck. The use of tissue expanders in the temporalis area further enhances the versatility of these flaps. The dimensions of the flaps can thus be enlarged to cover extensive defects in the neck region, and donor sites are closed primarily. Fifteen cases in which temporalis artery flaps were used are presented in this study, together with a discussion of details of their dissection and the use of tissue expanders in head and neck reconstruction.
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THE 1979 FIRE DISASTER (93 CASUALTIES) IN BRASOV (ROMANIA) -THE IMPORTANCE OF RAPID TRANSPORT AND UNITARY TREATMENT IN A HOSPITAL
(Aburel V., Visa L, Grigorescu D. - Romania)
We report and discuss the case of a fire disaster (93 casualties) produced by a blast in 1979. The importance is stressed of rapid transport by all means available to a single hospital, where a team of specialists should be formed (surgeons + intensive care specialists + medical organization experts) to ensure the proper sorting of patients (a major problem), primary care and the transformation of part of the hospital into a Bum Unit. The therapy should be unitary, as simple as possible and adequate for the high number of casualties; other specialists' assistance should be available on request. In view of the wide range of factors involved in such collective accidents, no particular model can be defined: this has to be generated by each specific situation.
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MASS DISASTERS IN GREECE
(lliopoulou E, Lochaitis A, Komninakis E, Poulikakos L, Asfour S, Chalkitis S, Tzortzis C. - Greece)
In our perpetually developing modem society, mass disasters tend to occur with increasing frequency, making the necessity of a great range of preventive measures, as well as coordination between State Authorities and volunteers, more and more imperative. What really aggravates the situation in a catastrophe is not only the number of casualties but also the disproportion between needs and means available (the latter being inadequate to meet demands). It is therefore of paramount importance to employ all available means and resources to attain full efficiency. The main goal of this article is to study to what degree these principles of action were applied in a mass accident that occurred in Eleusis (Greece) on 1 September 1992 and how these affected the final outcome of the patients, if indeed they did.
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